Journal of Thoracic Oncology最新文献

英文中文

A Response to the Letter to the Editor: “Sites of Primary Tumors as Crucial Points When Conducting Segmentectomy for NSCLC”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.11.031

Kazuo Nakagawa MD, Shun-ichi Watanabe MD, Masashi Wakabayashi MSC, Yuta Sekino MD

引用次数: 0

A Response to the Letter to the Editor: “Performance Optimization of CNN Model Based on Attention Mechanism in Patients With NSCLC”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.11.024

Sanja Dacic MD, PhD, John Abel PhD, Stephanie R. Hennek PhD, William D. Travis MD, Ignacio I. Wistuba MD

引用次数: 0

Comment on “Genome-Wide Analysis Identifies Nuclear Factor 1C as a Novel Transcription Factor and Potential Therapeutic Target in SCLC”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.07.017

Ziming Wang PhD, MD, Bo Tao PhD, MD

引用次数: 0

A Response to Letter to the Editor: “Considerations on Genetics and Treatment Factors in NSCLC Segmentectomy Outcomes”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.11.030

Kazuo Nakagawa MD, Shun-ichi Watanabe MD, Masashi Wakabayashi MSC, Yuta Sekino MD

引用次数: 0

Prognostic Impact of Non–Predominant Lepidic Components in Pathologic Stage I Invasive Nonmucinous Adenocarcinoma 病理Ⅰ期浸润性非黏液腺癌中非优势鳞状成分的预后影响

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.09.1442

Joonseok Lee MD , Jae Hyun Jeon MD , Jin-Haeng Chung MD, PhD , Jung Woo Son MD , Beatrice Chia-Hui Shih MD , Woohyun Jung MD , Sukki Cho MD, PhD , Kwhanmien Kim MD, PhD , Sanghoon Jheon MD, PhD

Introduction

This study investigated the prognostic impact of non–predominant lepidic components in invasive nonmucinous adenocarcinoma.

Methods

Patients who underwent lobectomy and were diagnosed with stage I nonmucinous, non–lepidic-predominant invasive adenocarcinoma based on pathologic findings were included. Tumors were staged according to the eighth edition of TNM classification and categorized on the basis of the presence of lepidic components in the final pathologic findings. Overall survival (OS) and recurrence-free survival (RFS) were analyzed before and after applying inverse probability of treatment weighting. Competing risk analyses for recurrence were also compared in the two groups.

Results

Of the 1270 patients, 858 (67.6%) had lepidic components (+). The pathologic stage and histologic grade were higher in the lepidic (−) group (p < 0.001, respectively). The 5-year OS and RFS were significantly worse in the lepidic (−) group than in the lepidic (+) group (OS: 88.2% versus 94.9%, p < 0.001; RFS: 79.4% versus 91.9%, p < 0.001). These trends were consistent after weighted analysis (OS: 92.4% versus 96.4%, p = 0.029; RFS: 85.6% versus 92.3%, p = 0.007). The 5-year cumulative incidence of any recurrence was 14.0% in the lepidic (−) group and 4.1% in the lepidic (+) group (p < 0.001). Multivariable Fine-Gray regression analysis found that the lepidic (+) group exhibited a lower risk of recurrence than did the lepidic (−) group (hazard ratio = 0.52, 95% confidence interval: 0.29–0.93, p = 0.031).

Conclusions

In pathologic stage I invasive nonmucinous adenocarcinoma, the presence of histologically diagnosed non–predominant lepidic components might be associated with a better prognosis after curative surgery.

导言：本研究调查了侵袭性非黏液性腺癌中非显性鳞状成分对预后的影响：本研究探讨了浸润性非黏液腺癌中非占优势的鳞状成分对预后的影响：方法：纳入接受肺叶切除术并被诊断为病理I期非黏液性、非鳞状上皮占优势的浸润性腺癌患者。根据第八版 TNM 分类法对肿瘤进行分期，并根据最终病理结果中是否存在鳞癌成分进行分类。在应用逆治疗概率加权法之前和之后，对总生存期（OS）和无复发生存期（RFS）进行了分析。还比较了两组患者的复发竞争风险分析：在1270例患者中，858例（67.6%）为鳞癌（+）。鳞癌（-）组的病理分期和组织学分级更高（P < .001）。鳞状上皮细胞（-）组的5年OS和RFS明显低于鳞状上皮细胞（+）组（OS：88.2%对94.9%，P在病理分期为I期的浸润性非黏液腺癌中，组织学非优势鳞状成分的存在可能与治愈性手术后较好的预后有关。

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引用次数: 0

Reducing Local Recurrence After Sublobar Resection: Not As Easy As It Seems

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.11.013

Nasser Altorki MD, Benjamin E. Lee MD

引用次数: 0

The Risk and Reversibility of Osimertinib-Related Cardiotoxicity in a Real-World Population 真实世界人群中奥希替尼相关心脏毒性的风险和可逆性

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.003

Minjung Bak MD , Hyukjin Park MD , Se-Hoon Lee MD , Nuri Lee MD , Myung-Ju Ahn MD , Jin Seok Ahn MD , Hyun Ae Jung MD , Sehhoon Park MD , Jinhyun Cho MD , Jihoon Kim MD , Sung-Ji Park MD , Sung-A Chang MD , Sang-Chol Lee MD , Seung Woo Park MD , Eun Kyoung Kim MD, PhD

Introduction

Although osimertinib, a third-generation EGFR tyrosine kinase inhibitor, as the first-line therapy for metastatic NSCLC was found to have substantial survival benefits, concerns have arisen regarding its potential cardiotoxicity, particularly in real-world clinical settings. We aimed to investigate the incidence, risk factors, and reversibility of osimertinib-related cardiotoxicity.

Methods

We analyzed 1126 patients with NSCLC treated with osimertinib from May 2016 to April 2023 in two cancer centers. Osimertinib-related cardiotoxicity was defined as a composite of osimertinib-related cardiac dysfunction (ORCD), newly developed arrhythmia, and cardiac death. Total follow-up duration was 20.6 (10.8–35.2) months.

Results

The osimertinib was administered for a median of 12.4 months. The incidence of osimertinib-related cardiotoxicity was 4.7%. Advanced age (adjusted hazard ratio with 95% confidence interval: 1.07 [1.04–1.09], p < 0.001), a history of heart failure (3.35 [1.67–9.64], p = 0.025), atrial fibrillation (3.42 [1.27–9.22], p = 0.015), and baseline low left ventricle strain (0.87 [0.79–0.96], p = 0.005) were independently associated with development of cardiotoxicity. The recovery rate of ORCD was 82.4%, which did not differ between patients who discontinued medication and those who did not.

Conclusions

In real-world practice, the incidence of osimertinib-related cardiotoxicity was 4.7%, including 3.4% for ORCD requiring cardiologic intervention, which is higher than previously reported. Given the long-term medication of osimertinib and increased mortality associated with cardiotoxicity, vigilant monitoring is crucial, especially in patients with advanced age, history of heart failure, atrial fibrillation, or decreased baseline left ventricular strain.

简介奥希替尼是第三代表皮生长因子受体酪氨酸激酶抑制剂，作为转移性非小细胞肺癌（NSCLC）的一线治疗药物，奥希替尼已显示出显著的生存优势，但其潜在的心脏毒性也引起了人们的关注，尤其是在实际临床环境中。我们旨在研究与奥希替尼相关的心脏毒性的发生率、风险因素和可逆性：我们分析了2016年5月至2023年4月在两个癌症中心接受奥希替尼治疗的1126例NSCLC患者。奥西美替尼相关心脏毒性定义为奥西美替尼相关心脏功能障碍（ORCD）、新发心律失常和心源性死亡的综合。总随访时间为20.6（10.8-35.2）个月：结果：奥西莫替尼的中位用药时间为12.4个月。与奥希替尼相关的心脏毒性发生率为4.7%。高龄（调整后危险比，95%置信区间；1.07 [1.04-1.09]，P <0.001）、心衰病史（HF；3.35 [1.67-9.64]，P = 0.025）、心房颤动（AF；3.42 [1.27-9.22]，P = 0.015）和基线左心室低应变（0.87 [0.79-0.96]，P = 0.005）与心脏毒性的发生独立相关。ORCD 的恢复率为 82.4%，停药和不停药的患者之间没有差异：结论：在现实世界中，与奥希替尼相关的心脏毒性发生率为4.7%，其中需要心脏介入治疗的ORCD发生率为3.4%，高于之前的报道。考虑到奥希替尼的长期用药以及与心脏毒性相关的死亡率升高，警惕性监测至关重要，尤其是对于高龄、有心房颤动、房颤病史或左心室基线应变降低的患者。

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引用次数: 0

Brief Report: Ivonescimab Combined With Etoposide Plus Carboplatin as First-Line Treatment for Extensive-Stage SCLC: Results of a Phase 1b Clinical Trial 简要报告：伊沃尼西单抗联合依托泊苷加卡铂一线治疗广泛期小细胞肺癌：Ib 期临床试验结果。

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.013

Zhiwei Chen MD , Lin Wu MD , Qiming Wang MD , Yan Yu MD , Xianling Liu MD , Rui Ma MD , Tao Li MD , Yan Li M.Med. , Xia Song M.Med. , Lin Li MD , Wei Zhao PhD , Qiaoyun Wang MD , Xiao Xu PhD , Shun Lu MD, PhD

Introduction

Ivonescimab is a humanized IgG1 bispecific anti–programmed cell death protein 1/vascular endothelial growth factor antibody. This study aimed to evaluate the safety and tolerance of ivonescimab combined with etoposide and carboplatin as first-line treatment in patients with extensive-stage SCLC and to explore the primary efficacy of this regimen.

Methods

Eligible patients received intravenous ivonescimab 3 mg/kg, 10 mg/kg, or 20 mg/kg every 3 weeks combined with etoposide and carboplatin for up to four cycles, followed by ivonescimab as maintenance. The primary end points were safety and objective response rate (ORR).

Results

Between April 23, 2021, and December 2, 2021, 35 patients were enrolled. At data cutoff (October 25, 2023), the median follow-up was 13.3 (range: 0.3–28.5) months. For all patients, the confirmed ORR and disease control rate were 80% and 91.4%, respectively. The ORR was 66.7%, 90.9%, and 76.2% at the dose of 3 mg/kg, 10 mg/kg, and 20 mg/kg, respectively. Grade more than or equal to 3 treatment-related adverse events (TRAEs) were observed in 21 patients (60%), and the most frequent toxicities were decreased neutrophil count (n = 8, 22.9%), decreased white blood cell count (n = 5, 14.3%), and anemia (n = 5, 14.3%). Grade more than or equal to 3 TRAEs occurred in 66.7%, 54.5%, and 61.9% of patients in 3, 10, and 20 mg/kg groups, respectively. TRAEs leading to death were reported in two patients (5.7%). Immune-related adverse events, most of them grade 1 or 2, occurred in 14 patients (40.0%).

Conclusions

Ivonescimab in combination with etoposide and carboplatin was well tolerated and found to have promising antitumor activity in extensive-stage SCLC.

简介伊沃尼西单抗是一种人源化IgG1双特异性抗PD-1/VEGF抗体。本研究旨在评估伊沃尼西单抗联合依托泊苷和卡铂作为广泛期小细胞肺癌（ES-SCLC）患者一线治疗的安全性和耐受性，并探讨该方案的主要疗效：符合条件的患者接受静脉注射依维莫司单抗（ivonescimab）3 mg/kg、10 mg/kg或20 mg/kg，每3周一次，与依托泊苷和卡铂联合使用，最多4个周期，然后使用依维莫司单抗作为维持治疗。主要终点是安全性和客观反应率（ORR）：2021年4月23日至2021年12月2日，35名患者入组。截至数据截止日（2023 年 10 月 25 日），中位随访时间为 13.3 个月（0.3-28.5 个月）。所有患者的确诊 ORR 和疾病控制率分别为 80% 和 91.4%。3毫克/千克、10毫克/千克和20毫克/千克剂量的ORR分别为66.7%、90.9%和76.2%。21名患者（60%）出现了≥3级治疗相关不良事件（TRAEs），最常见的毒性反应是中性粒细胞计数减少（8例，22.9%）、白细胞计数减少（5例，14.3%）和贫血（5例，14.3%）。3、10和20毫克/千克组分别有66.7%、54.5%和61.9%的患者发生≥3级TRAE。有 2 例患者（5.7%）报告了导致死亡的 TRAE。14名患者（40.0%）发生了潜在免疫学病因的不良反应，其中大部分为1级或2级：伊沃尼西单抗与依托泊苷和卡铂联合治疗ES-SCLC耐受性良好，并显示出良好的抗肿瘤活性。

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引用次数: 0

Lung Cancer in Argentina

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.016

Manglio Miguel Rizzo MD, PhD , Máximo Barros MD , Domingo Chimondeguy MD , Mercedes Liliana Dalurzo MD , Nicolás Minatta MD , Carmen S. Pupareli MD , Eduardo Richardet MD , Alejandro J. Videla MD , Gonzalo Recondo MD

引用次数: 0

Refining Risk Stratification for Locoregional Relapse in Clinical Stage IA Small-Sized Peripheral NSCLC After Segmentectomy

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.022

Pei-Hang Xu PhD, Jin Zhang PhD, Chaoyang Liang MD

引用次数: 0

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Journal of Thoracic Oncology

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